From
£5550
For some patients a mid face lift or a “SOOF” lift is combined with a lower eyelid blepharoplasty. Patients who have a drooping mid face with a loss of the youthful cheek prominence and nasolabial folds may benefit from a mid face lift.
A mid face lift can be performed using the same lower eyelid incision as for a transcutaneous lower eyelid blepharoplasty but in some patients an additional incision in the temple is required. The midface is released from its attachments to the underlying bone and can be lifted with the use of sutures (stitches) or with the use of a dissolvable implant, a midface Endotine implant. This implant dissolves over a period of 3-6 months in most patients, after the repositioned tissues of the mid-face have reattached to the underlying bone. The implants are very effective but add expense to the procedure. This surgery is more often undertaken under general anaesthesia with an overnight stay in hospital because of the extra time that this takes. This surgery is associated with a lot of postoperative facial swelling which takes some weeks to subside. The lengthy down time must be taken into consideration. A final result from surgery will not be seen for at least 4 months.
Some patients have “malar mounds” over the cheek bones. These are more commonly seen in smokers. These represent a loss of subcutaneous ligament support of the cheek and can be associated with fluid retention in this area. They can be very difficult to treat surgically and may require an alternative non-surgical approach e.g. laser resurfacing, radiofrequency treatment or they should be left alone.
You will visit the clinic to have a preoperative consultation. This usually lasts 45 minutes. You will be asked to complete a healthcare questionnaire, providing information about:
You will have your blood pressure checked by the nurses at the clinic.
It is very helpful if you have old photographs which you can bring along to the consultation. If you are happy to email digital photographs of your current appearance in advance of the consultation with details of your concerns, this is also enormously helpful and saves time. Your photographs will be kept confidential and will form part of your clinical record.
The nurses are also happy to answer any further questions and to show you the facilities at Face & Eye, including the operating theatre if it is not in use.
If you are unsure of the names of any medications, bring them with you.
You will be told whether or not to stop any medications at this preoperative clinic visit. For example, if you are taking aspirin-containing medicines or anticoagulants, they may need to be temporarily withdrawn or reduced in dose for two weeks before the procedure as long as these are not medically essential. You might need to check this with your GP. Any anti-inflammatory medicines e.g. Ibuprofen, Nurofen should be discontinued at least 2 weeks before surgery. These medicines predispose you to excessive bleeding. You will be given a leaflet advising you on what medications, foods, and vitamin supplements to avoid prior to surgery. Your blood pressure should also be under good control if you take medications for hypertension. This is very important.
If you can, try to stop smoking at least six to eight weeks prior to surgery. Smoking has an adverse effect on healing and damages your eyelid skin and supporting tissues and your eyes (it can result in premature cataract formation and age related macular degeneration with a loss of central vision).
Your vision in each eye will be measured. Your eyes will be examined carefully using a slit lamp (a special ophthalmic microscope).
Your tear film status is determined and the back of the eyes (called the retina) is examined as well as the eyelids themselves. The rest of your face is then examined. Photographs of your face and eyelids will be taken before surgery so that the results of surgery can be compared with your original appearance. The photographs are confidential and can only be used for any purpose other than your own records with your specific written permission.
N.B. The cost of cosmetic blepharoplasty and mid fae lift surgery is not covered by medical insurance companies.
The risks and potential complications of surgery should be considered but these need to be kept in perspective. Complications in the hands of a trained and experienced oculoplastic surgeon are very rare and all precautions are taken to minimize any risks.
Most complications of eyelid surgery are amenable to successful treatment.
Complications from upper eyelid blepharoplasty surgery include:
After surgery, the eyes are initially covered with pressure dressings for approximately half an hour to reduce postoperative swelling and the wounds are treated with antibiotic ointment. The dressings are then removed and replaced with cool packs. Activity is restricted for 2 weeks to prevent bleeding. For patients who undergo this surgery under general anaesthesia in hospital, the dressings may be kept in place overnight.
You will be asked to clean the eyelids very gently using clean cotton wool and Normasol (sterile saline) or cooled boiled water and repeat the application of antibiotic ointment (usually Chloramphenicol or Soframycin) to the wounds 3 times a day for 2 weeks. The sutures used are dissolvable but are usually removed in clinic after 2 weeks. The skin around the eyes should be protected from direct sunlight, by avoidance if possible or by using protective sunglasses. Wearing make-up should be avoided for at least 2 weeks. After 2 weeks the use of mineral make-up is recommended. (The nurses at the clinic can demonstrate this to you). It is important to devote a lot of time to your aftercare for the first 2 weeks and some patients find this somewhat labour intensive.
A realistic period of recovery must be expected. Postoperative bruising usually takes at least 2-3 weeks to subside completely. Swelling takes much longer. Most of the swelling disappears after 6 weeks but this can vary considerably from patient to patient as does the extent of the swelling. The final result is not seen for at least 4 months. This should be taken into consideration when scheduling the operation. You should arrange this surgery after holiday periods or important professional or social events and not before so that you are available for postoperative review and just in case any surgical adjustments are required.
The lower lid scars following a transcutaneous blepharoplasty and mid-face lift also fade to fine white marks just underneath the eyelashes with a few months. The scars at the outer aspect of the eyelids are more visible but can be camouflaged with make-up in female patients after 2-3 weeks.
You will need to use frequent artificial tears for the first 2-3 weeks following surgery. It is preferable to use preservative free drops if you have any allergies. These will be prescribed for you e.g. Hyabak drops, Systane eye drops preservative free, Viscotears preservative free, Liquifilm tears preservative free, or Celluvisc drops and Lacrilube ointment at bedtime.
It is often recommended that you use Lacrilube ointment to the eyes 2 hourly for the first 48 hours after surgery following any associated upper lid surgery but note that this will cause blurring of vision. (You should not drive for the first few days after surgery).
You are advised to sleep with the head raised approximately 30 degrees. It is preferable to raise the head of the bed if possible.
Contact lenses should not be worn for a few weeks following this type of surgery.
A period of postoperative massage is often advised following lower eyelid surgery. You will be shown how to do this. It is usually undertaken after applying some Lacrilube ointment to the eyelid skin. The massage helps to reduce swelling and to prevent eyelid retraction. It is usually undertaken for 3 minutes 3 times a day in an upward direction.